Objective To analyze the influencing factors of hospitalization costs in patients with occupational noise-induced deafness (ONID), and provide evidence for health policy development. Methods A total of 109 ONID patients in a hospital for occupational disease prevention and treatment in Guangdong Province were collected from 2018 to 2022 as the study subjects using a retrospective analysis method. Hospitalization information was collected, and influencing factors of hospitalization costs were analyzed. Results The average hospitalization cost per admission from 2018 to 2022 was 26 948.1, 27 805.0, 25 291.1,20 741.2 and 18 865.1 yuan, respectively, showing a downward trend. Grey relational analysis showed that the top three cost components most closely associated with the average hospitalization cost per admission were treatment expenses, medical service fees, and other expenses, with correlation coefficients of 0.786 1, 0.720 4, and 0.654 3, respectively. Univariate logistic regression analysis indicated that length of hospital stay was the primary influencing factor for average hospitalization cost per admission (P<0.01). Conclusion It is recommended to optimize clinical care pathways, improve diagnostic and treatment techniques, and reduce hospital stay duration, to lower the hospitalization costs of ONID patients.

ObjectiveTo explore the effect of occupational stress on work-related musculoskeletal disorders (WMSDs) in electronics manufacturing workers. Methods A total of 392 front-line workers in two electronic manufacturing enterprises in Guangdong Province were selected as the research subjects using the judgment sampling method. The prevalence of WMSDs and the level of occupational stress of the research subjects were investigated using the Musculoskeletal Disorders Questionnaire and the Core Occupational Stress Scale. Results The total WMSDs detection rate was 39.5%, and the multi-site WMSDs detection rate was 30.6%. The detection rate of occupational stress was 14.8%. The total WMSDs detection rate and multi-site WMSDs detection rate in the occupational stress group were higher than those in the non-occupational stress group (65.5% vs 35.0%, 56.9% vs 26.0%, both P<0.01). Binary logistic regression analysis result showed that the risk of WMSDs in the occupational stress group was higher than that in the non-occupational stress group after adjusting the effect of confounding factors such as age, gender, job type and work days per week (P<0.01). Conclusion The occupational stress may increase the risk of WMSDs in electronics manufacturing workers. Reducing the level of occupational stress among workers in electronic manufacturing enterprises is beneficial for reducing the risk of WMSDs.

Objective:To evaluate the efficacy and safety of dupilumab in the treatment of prurigo nodularis (PN) in the real world.Methods:PN patients who were subcutaneously injected with dupilumab for over 12 weeks were collected from the China Type Ⅱ Inflammatory Skin Disease Clinical Research and Standardized Diagnosis and Treatment Project Database from June 2021 to October 2022. Their clinical data were retrospectively analyzed, which included demographic data, and changes in pruritus numeric rating scale (NRS), investigator global assessment for PN-Stage (IGA PN-S), dermatology life quality index (DLQI) and hospital anxiety and depression scale (HADS) scores before and after treatment. Differences in scores before and after treatment, as well as in efficacy between patients with and without a history of atopic diseases, were analyzed using Wilcoxon signed-rank test, paired t-test or chi-square test. Results:A total of 66 PN patients were collected, including 42 males and 24 females, and they were aged 8 to 89 (44.12 ± 24.17) years. Thirty-six patients had a history of atopic diseases, and 27 had a family history of atopic diseases. After 12-week treatment with dupilumab, the pruritus NRS, IGA PN-S and DLQI scores in the 66 patients significantly decreased from the baseline scores (7.00 [5.00, 8.00], 3.00 [3.00, 4.00], 12.00 [7.75, 20.25], respectively) to 3.00 [2.00, 4.25], 2.00 [2.00, 3.00], 5.00 [1.75, 8.25], respectively (all P < 0.001). Among the 66 patients, 39 continued the regular treatment with dupilumab after 12 weeks and were followed up to 16 weeks; their pruritus NRS and IGA PN-S scores at week 16 further decreased compared with those at week 12 (both P < 0.05). There were no significant differences in the proportion of patients showing an improvement of ≥ 4 points in the NRS score or the proportion of patients achieving IGA 0/1 at week 12 between the patients with history of atopic diseases and those without (both P > 0.05). Before treatment, 32 PN patients were accompanied by mild to severe anxiety and/or depression; after 12-week treatment, the HADS-A scores in the 28 patients with anxiety (HADS-A scores > 7 points) and the HADS-D scores in the 20 patients with depression (HADS-D scores > 7 points) significantly decreased compared with their baseline scores (both P < 0.001) ; 18 (56.52%) patients achieved remission in anxiety and depression (both HADS-A and HADS-D scores < 7 points). Among the 66 PN patients, there were 13 minor patients, including 7 males and 6 females, and they were aged 8 to 17 (13.77 ± 3.09) years; after 12-week treatment, their pruritus NRS, IGA PN-S, and DLQI scores significantly decreased compared with the corresponding baseline scores (all P < 0.05) ; 8 minor patients continued dupilumab treatment for 16 weeks, with a further decrease in the IGA PN-S score compared with that at week 12 ( P < 0.05), but without significant differences between the pruritus NRS and DLQI scores at week 16 and those at week 12 (both P > 0.05). Adverse reactions were observed in 7 adult patients, including eye pruritus, local injection reactions, and systemic erythema accompanied by pruritus on the day of injection. No adverse reactions were reported in minor patients. Conclusion:In the real world, dupilumab could markedly alleviate pruritus, skin lesions, anxiety and depression symptoms in PN, improve the quality of life, and exhibited a good safety profile.

{L-End}Objective To establish the norm of Core Occupational Stress Scale (COSS) for electronic manufacturing industry workers in China. {L-End}Methods A total of 3 049 workers from five electronic manufacturing enterprises in four prefecture-level cities concentrated distribution of the electronics manufacturing industry in China were selected as research subjects using a stratified sampling method. COSS was used to investigate occupational stress levels, and the mean norm, percentile norm and threshold norms were established. {L-End}Results The average score of COSS for the electronic manufacturing industry workers in China was (43.5±7.4) points, and the average scores of social support, organization and reward, demand and effort, and autonomy dimensions were (9.5±3.1), (15.1±3.9), (13.1±3.0), and (5.7±2.0) points, respectively. A total score of 0.0-<47.0 points was determined as no occupational stress, 47.0-<51.0 points as mild occupational stress, 51.0-≤54.0 points as moderate occupational stress, and >54.0 points as severe occupational stress. {L-End}Conclusion The norm of COSS for workers in China's electronics manufacturing industry has been established, which can provide a reference for the evaluation and intervention of their occupational stress levels.

Objective To analyze result of the external quality assessment for laboratories of toxicological pathology diagnosis in organizations in China. Methods A total of 86 organizations that participated in the 2020-2021 external quality assessment in laboratory of toxicological pathology diagnosis (hereinafter referred to as "reference units") were selected as research subjects using convenient sampling method, and the assessment results were analyzed. Results The median of total score was 92, and the 0-100 percentiles were 64-100 in these 86 reference units. Among these reference units, 76 were rated as excellent, 10 as qualified, with the excellent and the qualified rate of 88.4% and 11.6%, respectively. No reference unit was rated as unqualified. The rates of excellence of the reference units in public health institutions, pharmaceutical research institutions, drug safety evaluation centers and testing companies were 95.7%, 84.2%, 85.7% and 86.7%, and the qualified rates were 4.3%, 15.8%, 14.3% and 13.3%, respectively. The distribution of excellence and qualification among the four types of reference units showed no statistical difference (P>0.05). The distribution of sample scores according to the three grades of poor, good, and excellent were 4.9%, 20.7%, and 74.5% in public health institutions, 8.6%, 23.7%, and 67.8% in pharmaceutical research institutions, 12.5%, 25.0%, and 62.5% in drug safety evaluation centers, and 5.4%, 17.5%, and 77.1% in testing companies. The proportion of excellence unit in public health institutions was higher than that in pharmaceutical research institutions (P<0.05). Conclusion The overall toxicological pathology diagnostic capabilities in China are good, and various types of reference units demonstrate comparable technical capabilities. However, there is a need for standardization of diagnostic terminology.

Objective:To compare the clinical efficacy and safety of single microneedle radiofrequency versus photodynamic therapy in the treatment of inflammatory lesions of moderate and severe facial acne vulgaris.Methods:Sixty patients with moderate to severe facial acne vulgaris were retrospectively collected from Guangzhou Institute of Dermatology between December 2021 and July 2022, including 30 patients who had received single microneedle radiofrequency treatment, and 30 patients who had received photodynamic therapy. There were no significant differences in the age, gender distribution, and severity of acne between the two groups (all P > 0.05). The patients in the microneedle radiofrequency group were treated with single microneedle radiofrequency once every 4 weeks for 2 sessions; those in the photodynamic therapy group received aminolevulinic acid-based photodynamic therapy once every 2 weeks for 3 sessions; patients in both groups were still treated with oral doxycycline for 8 weeks. After 8-week treatment, the efficacy, pain severity and incidence of adverse reactions were compared between the two groups. Statistical analysis was carried out by using chi-square test, two independent samples t-test and Mann-Whitney U test. Results:After 8-week treatment, there was no significant difference in the response rate between the microneedle radiofrequency group (93.33%, 28/30) and photodynamic therapy group (86.67%, 25/30; χ2 = 0.74, P = 0.389). No significant difference was observed in the pain severity score between the microneedle radiofrequency group (4.80 ± 2.08) and photodynamic therapy group (4.13 ± 1.86, t = 1.32, P = 0.194), and there was also no significant difference in the pain degree between the two groups ( Z = -1.13, P = 0.260). In the microneedle radiofrequency group, burning sensation occurred in 3 cases (10.00%), swelling and pain in 4 (13.33%), erythema in 2 (6.67%), and dryness and desquamation in 2 (6.67%), and no reactive acne or hyperpigmentation was observed; in the photodynamic therapy group, burning sensation occurred in 10 cases (33.33%), swelling and pain in 9 (30.00%), erythema in 8 (26.67%), reactive acne in 11 (36.67%), hyperpigmentation in 2 (6.67%), and dryness and desquamation in 11 (36.67%). Compared with the photodynamic therapy group, the microneedle radiofrequency group showed significantly decreased incidence rates of burning sensation, erythema, reactive acne, and dryness and desquamation ( χ2 = 4.81, 4.32, 13.47, 7.95, respectively, all P < 0.05) ; there was no significant difference in the incidence rates of swelling and pain as well as hyperpigmentation between the two groups ( χ2 = 2.46, 2.07, respectively, both P > 0.05) . Conclusion:Single microneedle radiofrequency showed marked efficacy equivalent to that of photodynamic therapy in the treatment of moderate to severe facial acne vulgaris, but higher safety, providing more clinical treatment options for moderate to severe facial acne vulgaris.

Abstract: Objective To explore the effect of optimal intervention on occupational stress in front-line workers of electronic manufacturing industry. Methods A total of 257 front-line workers in an electronic manufacturing industry were selected as the research subjects using the judgment sampling method. On the basis of the previous three-level prevention intervention model on occupational stress in labor-intensive enterprise workers，a two-year optimized "333" model of three-level prevention intervention on occupational stress was implemented in the research subjects. The pre-intervention and post-intervention occupational stress levels of job demand-control（JDC）and effort-reward imbalance（ERI）model in workers at this enterprise were evaluated using the Simple Job Stress Questionnaire and the ERI Questionnaire. Results Compared with those before intervention，the scores of job requirements dimension of JDC model，giving and intrinsic input dimensions of ERI model decreased after intervention（all P<0.01）；the scores of social support dimension of JDC model and that of return dimension of ERI model increased（all P<0.05），and the detection rates of occupational stress of both JDC and ERI models decreased （26.1% vs 10.1%，21.0% vs 8.9 % ，all P<0.01）. Conclusion Optimizing the "333" intervention mode for three-level prevention intervention of occupational stress can effectively alleviate the occupational stress levels of front-line workers in electronic manufacturing enterprises.

OBJECTIVE: To evaluate the diagnostic ability of toxicity pathology in patho-toxicological testing institutions in China. METHODS: The institutions participated in the 2018 Interlaboratory Comparison Activity of Toxicity Pathology Testing(hereinafter referred to as reference unit) were selected as the research subjects. The heart, spleen, skin, soft tissue, liver and mammary gland of SD rats of different groups in the 2-year carcinogenesis test were selected. The femur, knee joint and nose of Beagle dogs in the 4-week toxicity test and a total of 10 pathological tissues were selected as the comparison samples. The pathological diagnosis was carried out by the pathological diagnostic personnel of the reference unit, and the diagnostic results were reported. The expert appointed by the Toxicology and Pathology Committee of Chinese Toxicology Association compared the diagnostic results with the appointed value. RESULTS: A total of 167 pathological diagnostic personnel from 75 reference units in 24 provinces and municipalities participated in the comparison activity. The reference units were mainly distributed in East China, South China and North China, accounting for 77.3%(58/75). Totally 75 reference units fed back 750 effective diagnostic results. The qualified rates of diagnosis on heart, spleen, skin, soft tissue and breast samples were higher than 60.0%. The qualified rates of diagnosis on femur and knee joint, and nose samples were low(30.7% and 6.7%, respectively). There were 1(1.3%), 46(61.4%) and 28(37.3%) reference units rated as unqualified, qualified and excellent, respectively. CONCLUSION: Most of the testing institutions in China have a high level of patho-toxicological diagnostic ability, that can provide reliable diagnostic results for toxicology safety evaluation tests.

OBJECTIVE: To investigate the chronic toxicity and carcinogenicity of kresoxim-methyl in rats. METHODS: Specific pathogen free SD rats were randomly divided into control group and low-, medium-and high-dose groups according to the body weight of rats, 120 rats in each group with half male and half female rats. The chronic toxicity and carcinogenesis was induced in rats for 104 weeks by oral feeding. The dose of kresoxim-methyl in feed of male and female rats was 0, 75, 300 and 1 200 mg/kg. During the process of experiment, the body weight of rats was weighed. The blood biochemistry, organ coefficient and histopathology were examined at the end of the exposure, and the tumor incidence was calculated. RESULTS: There was no significant difference in mortality of the female or male rats in the four groups(P>0.05). At the 32 nd, 48 th and 56 th week after exposure, the body mass of female rats in the high dose group was lower than that in control group(P<0.05); at the 8 th, 16 th, 24 th and 32 nd week, the body mass of male rats in the high dose group was lower than that in the control group(P<0.05). The organ coefficients of heart and adrenal gland of female rats in the high dose group were higher than those in the control group and the low dose group(P<0.05). The organ coefficient of liver of male rats in the high dose group was lower than that in the control group(P<0.05). The alkaline phosphatase of male rats in the three dose groups was lower than that in the control group(P<0.05). The blood glucose of male rats in the high dose group was higher than that in the control group(P<0.05). The aspartate aminotransferase of male rats in the high dose group was lower than that in the control group(P<0.05). There was no significant difference among the three indexes in female rats(P>0.05). The tumor incidence of the control group and the low, medium and high dose groups were 68.3%, 75.0%, 75.0% and 78.8%, respectively, with no significant difference(P>0.05). The tumor incidence of the female rats was higher than that of the male rats(87.0% vs 61.5%,P<0.01).The tumor multiplicity of the above four groups were 38.3%, 35.8%, 35.0%, 39.8%, respectively, with no significant difference(P>0.05). The tumor multiplicity in female rats was higher than that in male rats(56.9% vs 17.6%,P<0.01). CONCLUSION: The no observed adverse effect level of kresoxim-methyl to female and male SD rats was 24.726 and 20.002 mg/(kg·d), respectively. No carcinogenicity of kresoxim-methyl to SD rats was observed.

OBJECTIVE: To observe the pathological changes of rat silicosis model at different time points. METHODS: The specific pathogen free SD rats were randomly divided into control group and 7, 15, 21, 30, 45, 60, 75 and 90 day model groups based on their body weight, with 5 rats in each group. Non-exposed endotracheal intubation was performed. Silicosis rat model was established by intratracheal instillation of 250 g/L silica suspension in each rat, and 0.9% sodium chloride solution was perfused into the trachea of rats in the control group. The rats in the control group were sacrificed on the 90 th day after exposure, and the model rats in the other 8 groups were sacrificed on the 7 th, 15 th, 21 st, 30 th, 45 th, 60 th, 75 th and 90 th days after the end of exposure. The gross appearance of the lung tissue of rats was observed. The rat lung tissues were stained with hematoxylin-eosin and Masson staining to observe the pathological changes, and Ashcroft score was evaluated. RESULTS: The gross observation showed that the lungs of rats in the model groups had varying degree of gray changes, hardened texture, and spots and nodules on the surface of the lobes. These changes were aggravated with the increase of time after dust exposure. The results of histopathological examination of the lungs showed that the rats developed acute alveolar inflammation, and a large number of macrophages and neutrophils were seen in the lung tissues in the 7 th and 15 th day model groups. Cellular nodules appeared in the lung tissue, and fibrosis appeared in the center of the nodule in the rats of 21 st, 30 th, and the 45 th day model groups; the silicosis nodules appeared in the lung tissues of rats in the 60 th, 75 th, and 90 th day model groups, and the small nodules gradually merged into larger ones. Simultaneously, with the increase of time after dust exposure, the lung tissue of rats gradually showed severe pulmonary fibrosis. The lung organ coefficient and Aschcroft score of rats increased with the increase of time after dust exposure(P<0.01). CONCLUSION: The rat lung changes after dust exposure. Acute alveolar inflammation occurs on the 7 th to 15 th day after dust exposure; cellular nodules develop on the 21 st to 45 th day after dust exposure; silicosis nodules develop on the 60 th to 90 th day after dust exposure. The severity of lung fibrosis after dust exposure showed a time-effect relationship in rats.